It would be difficult if not impossible to state the number of times we’ve heard from family members or friends of hoarders, or people who watch the TV shows: “Just go in and clear it all out—get rid of everything!” This is a very understandable response to what we see in a hoarder’s home. It’s usually filthy and hard to walk through or even get into, the space is unusable for what its intended purpose, it may smell awful and be highly unsanitary due to animal waste, but the hoarder who lives there doesn’t see it the way nonhoarders do. To them, there is value in the most insignificant piece of trash, and their sense of safety and of who they are, their very identity, is found in their possessions.

"Hoarding is a complex disorder believed to be associated with four underlying characteristics.

Certain core vulnerabilities including ... depression or anxiety along with family histories of hoarding and generally high levels of perfectionism.

Difficulties processing information. In particular, … problems in attention (including ADHD-like symptoms), memory, categorization, and decision-making. (The areas of the brain that control these functions roughly correspond to brain regions that have been shown to activate differently in people who hoard.)

Intense emotional attachments to a wider variety of objects than do people who don’t hoard. These attachments take the form of attaching human-like qualities to inanimate objects, feeling grief at the prospect of getting rid of objects, and deriving a sense of safety from being surrounded by possessions.

Beliefs about the necessity of not wasting objects or losing opportunities represented by objects."

A careful review of this information can enlighten us to the futility of having a junk hauling service come in and do what they call a "trash-out," just clearing and hauling away the contents of the home without taking the owner's concerns into account. If we think the hoarder will react the way we hope, we will be sadly mistaken. Hoarders do NOT simply accept that someone—anyone—has taken away all their “stuff.” To them this can seem as if they have been stripped of their identity, their safety, everything they hold valuable. It can be so bad that they go into a state of rage, depression, and despair, and simply repeat their hoarding behavior until the situation is the same as it was—and the trust they may have had for the well-intentioned “helpers” is destroyed.

Eugenia Lester, the mother in My Mother's Garden, a film by her daughter Cynthia, is devastated when she returns home to find it empty of all her possessions.

Eugenia breaks down in her empty living room.

"Can’t Compulsive Hoarding Be Solved by Simply Cleaning Out the Home?"No. Attempts to 'clean out' the homes of people who hoard without treating the underlying problem usually fail. Families and community agencies may spend many hours and thousands of dollars clearing a home only to find that the problem recurs, often within just a few months. Hoarders whose homes are cleared without their consent often experience extreme distress and may become further attached to their possessions. This may lead to their refusal of future help.”[Excerpt from the International OCD Foundation’s Hoarding Fact Sheet, available here]

However, with proper care in the clean-out process, in which the client is treated with respect and compassion, in which the workers examine every item for potential value and are trained to listen to the client in a nonjudgmental way, a clean-out can proceed smoothly and less painfully. This is NOT something a trash-removal company is equipped to do. It takes years of experience dealing with hoarders in all manner of situations to accomplish this successfully. The clean-out doesn’t have to take a very long time if it’s conducted properly.

A company such as Clutter & Hoarding Pros™, whose owner, Michelle Quintana, earned her Masters Degree in Clinical Psychology, has completed thousands of hours with hundreds of hoarders and knows exactly how to communicate and work with these clients. She and her team do not rush the clients or force them to give up their possessions until they’re ready, and they strive to create an atmosphere of cooperation and support. They work with municipal and other resources when necessary and champion the client with outside professionals. They also know how to educate both the client and family and friends who are willing to help their loved one recover. The vital role of a sympathetic, compassionate, nonjudgmental, yet firm and confident clean-out team paves the way for recovery by the hoarder, not a tragic repetition of the problem.

Following is a brief summary of treatment strategies after the hoard has been cleared.

Can Compulsive Hoarding Be Treated?Yes, compulsive hoarding can be treated. Strategies to treat hoarding include:

Challenging the hoarder’s thoughts and beliefs about the need to keep items and about collecting new things

Going out without buying or picking up new items

Getting rid of and recycling clutter. First, by practicing the removal of clutter with the help of a clinician or coach and then independently removing clutter

Finding and joining a support group or teaming up with a coach to sort and reduce clutter

We hope that if you are, or are involved in helping, a hoarder, you will proceed with this information in mind to create a clean-out situation in which the problem can result in a successful recovery from this debilitating condition.